House File 834 - Introduced HOUSE FILE BY SWAIM Passed House, Date Passed Senate, Date Vote: Ayes Nays Vote: Ayes Nays Approved A BILL FOR 1 An Act relating to reimbursement for prescription drug expenses 2 by certain providers of health benefit coverage. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 2590HH 82 5 av/je/5 PAG LIN 1 1 Section 1. NEW SECTION. 514C.23 PRESCRIPTION DRUG 1 2 REIMBURSEMENT. 1 3 1. A provider of third=party payment or prepayment of 1 4 prescription drug expenses that reimburses covered individuals 1 5 or pharmacies for prescription drug expenses of a covered 1 6 individual pursuant to a health benefit coverage policy, 1 7 contract, or plan shall provide reimbursement to the covered 1 8 individual or pharmacy not more than two weeks after receiving 1 9 a claim for reimbursement. 1 10 2. This section shall not apply to prescription drug 1 11 coverage provided through or in conjunction with any of the 1 12 following: 1 13 a. Accident=only or disability income insurance coverage. 1 14 b. Hospital confinement indemnity coverage. 1 15 c. Coverage issued as a supplement to liability insurance. 1 16 d. Basic hospital and medical=surgical expense coverage. 1 17 e. Liability insurance, including general liability 1 18 insurance and automobile liability insurance. 1 19 f. Workers' compensation or similar insurance. 1 20 g. Automobile medical payment insurance. 1 21 h. Credit only insurance. 1 22 i. Coverage for on=site medical clinic care. 1 23 j. Dental or vision coverage. 1 24 k. Benefits for long=term care, nursing home care, or 1 25 community=based care. 1 26 l. Short=term hospital, medical, or major medical 1 27 coverage. 1 28 m. Medicare supplemental as defined pursuant to 42 U.S.C. 1 29 } 1395ss(g)(1), coverage supplemental to the coverage provided 1 30 under 10 U.S.C. } 1071=1109, and similar coverage that is 1 31 supplemental to coverage under group health insurance coverage 1 32 as defined by the commissioner of insurance. 1 33 n. Any other similar limited benefits as defined by the 1 34 commissioner of insurance. 1 35 3. As used in this section, unless the context otherwise 2 1 requires: 2 2 a. "Prescription drug" means prescription drug as defined 2 3 in section 155A.3 and includes a device as defined in section 2 4 155A.3. 2 5 b. "Provider of third=party payment or prepayment of 2 6 prescription drug expenses" or "provider" means a provider of 2 7 an individual or group policy of accident or health insurance 2 8 or an individual or group hospital or health care service 2 9 contract issued pursuant to chapter 509, 514, or 514A, a 2 10 provider of a plan established pursuant to chapter 509A for 2 11 public employees, a provider of an individual or group health 2 12 maintenance organization contract issued and regulated under 2 13 chapter 514B, a provider of an organized delivery system 2 14 contract regulated under rules adopted by the director of 2 15 public health, a provider of a preferred provider contract 2 16 issued pursuant to chapter 514F, a provider of a self=insured 2 17 multiple employer welfare arrangement, and any other entity 2 18 providing health insurance or health benefits which provide 2 19 for payment or prepayment of prescription drug expenses 2 20 coverage subject to state insurance regulation. 2 21 EXPLANATION 2 22 This bill provides that certain providers of third=party 2 23 payment or prepayment of prescription drug expenses that 2 24 reimburse covered individuals or pharmacies for prescription 2 25 drug expenses pursuant to certain health benefit coverage 2 26 policies, contracts, or plans are required to provide such 2 27 reimbursement to the covered individual or pharmacy not more 2 28 than two weeks after receiving a claim for reimbursement. 2 29 LSB 2590HH 82 2 30 av:nh/je/5